Since HPV vaccines were introduced almost a decade ago, there has been a fear that vaccinating young girls against sexually transmitted infections will give them license to have sex and increase promiscuity. A new study suggests that the opposite may in fact be true—girls who have been vaccinated are less likely to engage in risky sexual behavior than those who have not.

Since HPV vaccines were introduced almost a decade ago, there has been a fear that vaccinating young girls against a sexually transmitted infection (STI) would lead to increased promiscuity.

There is a large and growing body of evidence that this fear is unfounded, and now a study out of the United Kingdom suggests that the opposite may in fact be true—girls who have been vaccinated are less likely to engage in risky sexual behavior than those who have not.

The UK since 2008 has offered HPV vaccines to all girls ages 12-to-13 as well as a catch-up program that provides vaccines to any woman born after 1990. For this study, researchers reviewed medical records of 363 young women who attended clinics in Northwest England and compared markers of sexual behavior—such as pregnancy tests or sexually transmitted disease (STD) diagnoses—among those who had been vaccinated to those of their unvaccinated peers.

Sixty-three percent of those studied had received one of the three recommended doses of the vaccine.

Researchers found five variables showing significant differences between women who had been vaccinated and those who had not, but all five showed that the vaccinated had lower levels of sexual risk. Those who were not vaccinated were more likely to have had three or more sex partners in the past six months, had anal sex during their last sexual encounter, have gone to the clinic with symptoms of an STD, and have tested positive for chlamydia at their last clinic visit.

In contrast, women who had been vaccinated were more likely to use condoms.

The authors and other public health experts have given a number of possible explanations for these behavioral differences. In the UK, where the government offers vaccinations to everyone, vaccination rates are high. Failure to vaccinate, therefore, may be a marker of other high risk sexual behavior, according to the authors.

On the flip side, the report’s authors explain that “vaccination was taken up by those demonstrating other types of prevention or less risky behaviors.” This does not surprise those in the public health field.

Dr. Jessica Kahn, a professor of pediatrics at Cincinnati Children’s Hospital Medical Center, told Reuters: “Preventive health behaviors tend to cluster, so it makes sense that girls who practice safer behaviors are more likely to be vaccinated.”

Of course, the correlation could go the other way as well. “One explanation for the findings is that girls who are vaccinated receive education about sexual health and prevention which decreases riskier behaviors,” Kahn said.

Either way, the study should be seen as good news to those who are worried that providing vaccines to girls and young women will somehow lead to riskier sexual behavior. And these results echo those of many other studies, including a December study that reviewed the records of 260,000 young women in Ontario and found no evidence that receiving the vaccine led to increased risk of either an unintended pregnancy or an STD.

“These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age,” the authors of that study concluded.

HPV is a very common STI. The Centers for Disease Control and Prevention estimates that 79 million people in the United States are infected with HPV and 14 million new infections occur annually. Though most people will suffer no long-term health consequences and may never know they have HPV, others may develop cervical cancer or cancers of the head, neck, throat, penis, or anus.

About 12,000 women develop cervical cancer in the United States each year and 4,000 die from it.

The HPV vaccine was approved in by the U.S. Food and Drug Administration in 2006, but uptake has been relatively slow due in part to skepticism about vaccines in general and to the unfounded fear that providing the vaccine will lead to promiscuity.

Gardasil 9, the newest version of the HPV vaccine to be approved by the FDA, has the potential to prevent 90 percent of cases of cervical, vulvar, vaginal, and anal cancers, but only if the vaccine becomes more widely accepted.

The Food and Drug Administration last month approved a new version of the human papillomavirus (HPV) vaccine Gardasil, which is designed to prevent nine strains of the virus. Public health experts suggest that use of this vaccine, called Gardasil 9, has the potential to prevent 90 percent of cases of all cervical, vulvar, vaginal, and anal cancer, but they stress that this can only happen if the vaccine becomes more widely accepted.

Gardasil, which was introduced in 2006, was the first HPV vaccine to be approved by the FDA. It provides protection against four strains of the virus: 6, 11, 16, and 18.

Strains 6 and 11 cause almost all cases of genital warts, and 16 and 18 are thought to cause 70 percent of cervical cancer cases. A second vaccine, Cervarix, which was approved in 2009, only protects against types 16 and 18. By adding protection against five additional cancer-causing strains (31, 33, 45, 52, and 58), Gardasil 9 has the potential to prevent almost all cases of cervical cancer as well as other HPV-associated cancers.

In fact, in a clinical trial Gardasil 9 was determined to be 97 percent effective in preventing cervical, vulvar, and vaginal cancers caused by the five additional cancer-causing strains.

The new vaccine, like the old, is given as a series of three shots over the course of eight months.

HPV is a highly contagious sexually transmitted infection. The Centers for Disease Control and Prevention (CDC) estimates that 79 million people in the United States are infected with the HPV virus and 14 million new infections occur annually. Though most people won’t suffer long-term health consequences and may never know they have the virus, others may develop cervical cancer or cancers of the head, neck, throat, penis, or anus.

About 12,000 women develop cervical cancer and 4,000 die from HPV every year in the United States. An estimated 3,000 new cases of HPV-associated anal cancers are diagnosed in women and about 1,700 in men. The CDC estimates that 360,000 people get genital warts caused by HPV.

HPV is actually a group of more than 150 related viruses that can infect various parts of the body. There are 40 strains of the virus that are known to be spread through sexual activity.

Research shows the vaccines are working. A 2013 study found that despite the fact that half of teen girls had gotten one dose of the vaccine and fewer than a third had gotten the recommended three doses, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

Another study found that states with high HPV vaccination rates had lower rates of cervical cancer, and vice versa.

The vaccines have been controversial since they were introduced; this is reflected in low vaccination rates. The HPV vaccine has suffered largely due to the general movement against vaccinations, which seems to have begun with falsified data suggesting a link between vaccines and autism. The data and the researchers who published it have been thoroughly discredited, but skepticism about vaccinations remains among some segments of the public.

HPV vaccines are even more controversial than others because they protect against a sexually transmitted infection. Some fear that discussing STI prevention with young teens and providing them with protection in the form of a vaccine will encourage sexual activity. A number of studies have found that there is no difference in the behavior or beliefs of young people based on whether they have or have not been vaccinated.

Experts hope that as the new vaccine is introduced, parents will focus less on the STI and more on the fact that we now have the ability to prevent cancer.

“Imagine being the first generation to eliminate a cancer. With vaccines, pap tests, and HPV tests, we have all the tools we need to prevent cervical cancer,” Deborah Arrindell, vice president of health policy at the American Sexual Health Association, told RH Reality Check. “The big challenge remains getting shots into arms—that has to be a priority.”

]]>http://rhrealitycheck.org/article/2015/01/08/new-hpv-vaccine-prevent-vast-majority-cases-several-cancers/feed/0This Year in Sex: We’re Living in the Futurehttp://rhrealitycheck.org/article/2014/12/17/year-sex-living-future/?utm_source=rss&utm_medium=rss&utm_campaign=year-sex-living-future
http://rhrealitycheck.org/article/2014/12/17/year-sex-living-future/#commentsWed, 17 Dec 2014 14:43:57 +0000http://rhrealitycheck.org/?p=51135

Between the high-tech sex toys, transplanted uteri, lab-grown penises, and perils of hookup apps, 2014 sometimes sounded like a science fiction novel. But we can't forget the news about IUDs and STIs that came out this year, either.

This Year in Sex takes a look back at the news and research related to sexual behavior, sexuality education, contraception, sexually transmitted infections, and other topics that captured our attention in 2014.

The HPV Vaccine Works, It Doesn’t Cause Promiscuity, and There’s an Even Better One Coming

HPV and its vaccine made headlines many times this year. The upsetting news is that two new studies came out suggesting that we had been underestimating the number of both HPV cases and cervical cancer, but as far as the vaccine itself was concerned, things were looking pretty good.

First, and most importantly, it appears to be working. A 2013 study found that despite the fact that only half of teen girls had gotten one dose of the vaccine—and fewer than a third had gotten the recommended three doses—the proportion of teen girls infected with the HPV strains that the vaccine addresses has dropped by 56 percent. This year, another study confirmed this success when it found that states with high rates of HPV vaccines have lower rates of cervical cancer, and vice versa.

Additional research this year should (though probably won’t) also put to rest the idea that giving young people the HPV vaccine encourages them to engage in sexual behavior. One study found that young women do not change their attitudes or behaviors toward safer sex if they get the shot, and the other showed that girls with the vaccine are no more likely to get pregnant or be tested positive for a sexually transmitted infection than their unvaccinated peers.

More good news: Last week, the Food and Drug Administration (FDA) approved a new version of Gardasil, one of the two HPV vaccines on the market, which will protect against more strains of the virus. The original vaccine protected against strains 11 and 6, which cause most genital warts, and strains 16 and 18, which cause 70 percent of cervical cancer. The new vaccine, called Gardasil 9, will protect against these four strains in addition to five more cancer-causing strains—31, 33, 45, 52, and 58. Public health experts are hopeful that this added defense can prevent 90 percent of cervical, vulvar, vaginal, and anal cancers.

Wins and Losses for Those Who Want Condoms in Porn

Last year ended with a shutdown of filming—the third of its kind in 2013—in the porn industry after another actor was found to be HIV-positive. So it should be no surprise that this year included numerous rounds in the battle between producers who say no one wants to see condoms on film and public health experts who insist safer sex should start on set.

An effort to get California to pass a statewide law mandating condom use ultimately failed after facing a lot of opposition from porn company representatives, who threatened to take their business to a friendlier state, and porn stars who said it would force their industry underground and make their work more dangerous.

Defenders of the ban, however, did get an end-of-year victory this week when Measure B—a Los Angeles County ordinance requiring condoms on adult industry sets—was upheld by the Ninth Circuit Court of Appeals. A lower court had formerly upheld the measure, though it has yet to be systematically enforced.

The IUD Gains Supporters and Users

The intrauterine device (IUD) was once one of the more popular methods of birth control available. Then one model, the Dalkon Shield, came on the market with numerous design flaws that caused many users to become infertile, even resulting in several deaths. Though the dangers were unique to Dalkon Shield, women and physicians became suspicious of all IUDs; for many years, very few women—and only those who had already had children—would use them for contraception. In the last few years, however, IUDs have started getting more attention as providers and public health experts note the safety of newer models and the unparalleled efficacy rates.

This year, the IUD gained even more supporters, such as the American Academy of Pediatrics, which came out with a recommendation in October suggesting that IUDs be considered a first-line contraception for sexually active young people. Three months prior, research out of Colorado suggested that increasing the number of young women at Title X clinics using long-acting reversible contraceptives (which include both IUDs and implants) had led to lower than expected fertility rates among low-income women ages 15-to-24 in the state.

Other states, even conservative ones, decided this year that fixing the way Medicaid pays for IUDs—to make it possible to obtain one in a single visit, or even while still in the hospital after delivering a baby—could help prevent unintended pregnancies.

All of this support seems to be translating into increased use of the method. The National Survey of Family Growth found that 6.4 percent of contraceptive users were using an IUD in 2011-2013, compared to just 3.5 percent in the 2006-2010 survey.

Lab-Grown Penises and Transplanted Uteri

The future of reproductive health may include penises grown in a lab and babies born from transplanted uteri.

This year, the first baby to grow in a transplanted uterus was born to a 36-year-old Swedish woman whose name is being withheld. The woman, like the nine others who began the trial, had functioning fallopian tubes but was born without a uterus. After she received a donor organ from a friend of the family, doctors put her on anti-rejection drugs immediately. She became pregnant using IVF and had a relatively uncomplicated pregnancy, though the baby was delivered at 32 weeks when she showed signs of preeclampsia.

The medical team who undertook the trial hailed this as great news for assisted reproductive technologies, but others have expressed worry that the procedure is too invasive for both the donor and the recipient. Two of the nine women in the original study had to have their donor uteruses removed.

Meanwhile, no one has yet to be given a lab-grown penis, but new research on rabbits publicized in October suggests that it’s just a few years off. The process starts with a donor organ that is first stripped of its cells, then seeded with two different types from the genitals of the intended recipient. By making the penis out of the recipient’s own cells, scientist say they are reducing the chance of organ rejection. The procedure was tested on 12 rabbits; all successfully tried to mate using their engineered penis, eight were able to ejaculate, and four impregnated their bunny partner.

Truvada Dominates HIV-Prevention Discussion

Truvada is a combination of two antiretroviral drug used to treat individuals who have HIV. When used daily in HIV-negative individuals, these drugs have been shown to prevent transmission of the virus. The FDA approved the use of Truvada as a form of pre-exposure prophylaxis (PREP) in 2011 and it has been gaining popularity ever since.

This year, both the Centers for Disease Control and Prevention and the World Health Organization released guidelines suggesting that those at high risk of HIV infection—including injection users and men who have sex with men who are not in a monogamous relationship—consider using Truvada.

The method is highly effective. Studies have found that men who take it every day can reduce their risk of HIV infection by as much as 92 percent.

Still, some HIV advocates are concerned that those who choose Truvada—which can cost as much as $10,000 a year and needs to be taken every day—will stop using condoms, putting themselves and their partners at increased risk of other STIs, such as gonorrhea or syphilis.

The Dangers of Mixing Sex and Technology

The intersection between technology and sex got a little tricky this year as officials pointed to a dating app, Grindr, as being at least partially responsible for a syphilis outbreak; meanwhile, a jury in California found that an STI dating site called PositiveSingles had been sharing private information.

Grindr uses global positioning technology to help users meet other users nearby who are interested in getting together, presumably for sex. Grindr is marketed to men who have sex with men, but similar apps exist for heterosexual couples and women who have sex with women. This March, the popular app was at the center of an outbreak of syphilis in Onondaga County, New York.

A few months later, research in Los Angeles found that men who have sex with men who met partners on apps like Grindr had a 25 percent greater incidence of chlamydia and a 37 percent greater incidence of gonorrhea than those who met men in person at a bar, club, gym, private sex party, or even an online dating site. There was no difference in HIV rates or syphilis rates based on where men met.

The online dating sites, however, might pose another problem, at least according to a California jury that awarded 16.5 million dollars last month to a man who says the dating website PositiveSingles—which advertises itself as a place where people can meet other people living with STIs—violated consumer law and committed fraud by sharing information among many other niche websites owned by the same company. As the plaintiff’s attorney put it: “[my client] is not Black, gay, Christian or HIV positive and was unaware that [the] defendant was creating websites that focused on such traits that would include his profile, thus indicating that he was all of these things and more.”

Always a New Sex Toy

Finally, lest anyone worry that we will get bored heading into the new year, we take a look at the sex toys that emerged in the public eye in 2014. There’s the Svakom Gaga, a new vibrator introduced by a Chinese company that comes equipped with a camera and a USB port—plug it into your computer and star in your very own vulva video.

Of course, if you’re not ready for your close-up or you live far from your partner, you could instead turned to the OhMiBod, a vibrator that can be controlled from an iPhone via Bluetooth.

And, for the fitness buffs who aren’t satisfied knowing that they took their 10,000 steps a day, there is the kGoal, a U-shaped device that counts kegels. Women put one side of the device inside their vagina and the hook the other to their phones and are able to know exactly how many times they squeezed their pelvic floor muscles. Known as kegels, these exercises have been shown to help during childbirth, prevent or control urinary incontinence, and improve orgasms.

A study this week adds to the large body of research that shows teens who have received the HPV vaccine are no more likely to engage in sexual activity or suffer consequences such as unintended pregnancy or STIs than their un-vaccinated peers.

The fear that vaccinating girls and boys against a sexually transmitted infection as young as 11 will increase promiscuity is thought to be a central reason that HPV vaccination rates are lower than that of other recommended vaccines. Research continues to show this worry is unfounded.

A new study published in the Canadian Medical Association Journal is the latest addition to a large of body of research that shows teens who have received the HPV vaccine are no more likely to engage in sexual activity or suffer adverse consequences than their un-vaccinated peers.

The researchers based their findings on outcomes of sexual activity, such as pregnancy or diagnosis with a sexually transmitted infection (STI). They used health databases in Ontario to examine the records of more than 260,000 girls, some of whom had gotten the vaccine and some who had not. As of 2007, all Ontario eighth-grade girls are eligible to receive the vaccine but only about half get all three doses.

The records revealed more than 10,000 pregnancies and 6,000 STIs by the time the girls had reached 10th-12th grade. Researchers, using an analysis technique known as regression discontinuity, found no evidence that vaccination increased the risk of these outcomes.

The authors concluded, “These results suggest that concerns over increased promiscuity following HPV vaccination are unwarranted and should not deter from vaccinating at a young age.”

As RH Reality Check has reported for a few years, many studies have had similar findings. One of the most recent studies, published this year in Pediatrics, examined the perceptions of young people who had received the vaccine to determine if they were less motivated to practice safer sex. Participants were also asked about their sexual behavior. Both the attitude and behavior surveys were given right after they received the vaccine and repeated two months and then six months later.

The findings showed that the vaccine did not change attitudes about sexual behavior, nor did it encourage unsafe sexual practices. Among those who were sexually active when they got the vaccine, 61 percent said they had used a condom the last time they had sex during the two-month survey, and 62 percent said so during the six-month survey.

A study by the Centers for Disease Control and Prevention (CDC) found that having received the HPV vaccine is not associated with whether a woman is sexually active or with the number of partners she has had. That study, published in 2012, also found that among people 15 to 19, those who had received the HPV vaccine were more likely to always use condoms than those who had not.

Another 2012 study used methodology similar to the Canadian study. It followed 1,400 girls in Atlanta for three years after their vaccination and compared them to girls who had received other vaccinations, but not the one for HPV. This research looked at markers for sexual behavior such as being given a pregnancy test, requesting contraceptive counseling, or receiving an STI diagnoses.

Again, there were no differences between the girls in the study who had received the HPV vaccine and the girls who had not received the vaccine.

HPV is a highly contagious STI. The CDC estimates that 79 million people in the United States are infected with HPV and 14 million new infections occur annually. Though most people will suffer no long-term health consequences and may never know they have HPV, others may develop cervical cancer or cancers of the head, neck, throat, penis, or anus.

About 12,000 women develop cervical cancer in the United States each year and 4,000 die from it.

There are two HPV vaccines on the market. Gardasil was introduced in 2006 and provides protection against four common strains of the virus, including the two that account for 70 percent of cervical cancers and the two that account for 90 percent of genital warts. A second vaccine, called Cervarix, was approved in 2009 and protects against the two strains that cause most cervical cancer.

Research has shown that the vaccines are working. A 2013 study, for example, found that despite the fact that only half of teen girls had gotten one dose of the vaccine and fewer than a third had gotten the recommended three doses, the proportion of teen girls infected with the HPV strains that the vaccine addresses has dropped by 56 percent.

Despite this success, many teens are not vaccinated in the United States, possibly because of concerns about promiscuity. Canada is facing a similar problem.

Even though Canada’s government-sponsored health program offers the vaccine to eighth-grade students, many remain un-vaccinated. Leah M. Smith, the lead author of the most recent study, pointed out in an email to news outlets that some Catholic schools in Ontario were opting out of the vaccine program altogether out of fears of somehow sanctioning sexual behavior.

“Our study was almost 200 times larger than the previous study and found no evidence of an increase in risk,” Smith said. This is consistent, she added, with studies of other efforts to improve sexual health.

“Other studies have consistently shown that sexual health interventions do not increase risky sexual behavior, and some may even promote safer sexual behaviors,” she said. “This includes interventions aimed at improving condom access in schools and providing sexual health education to teens.”

A new study finds that cervical cancer rates and HPV vaccination rates tend to move up and down together, suggesting once again that if more young women get vaccinated there will be fewer cases of cervical cancer.

More proof that vaccinating young people against human papillomavirus (HPV) can prevent cervical cancer was presented this week at a health disparities conference, as a national study found that there are fewer cases of cervical cancer in states in which HPV vaccines are more common.

Distrust of vaccines—based largely on dubious information—and fear that the vaccine might encourage promiscuous sexual behavior among teenage girls could be factors in states with the lowest HPV vaccination rates and the highest cervical cancer occurrences. Numerous studies have shown that the vaccine does not encourage promiscuity.

The study, presented at a conference organized by the American Cancer Research Association, pointed to a number of states on opposite ends of the spectrum. In Massachusetts, for example, 69 percent of girls ages 13 to 17 receive at least one dose of the vaccine, which is given as a series of three shots six months apart, and only six out of 100,000 women are diagnosed with cervical cancer each year.

Sixty-six percent of young women in Vermont have received at least one dose of the vaccine and 5.4 women out of 100,000 are diagnosed each year.

In contrast, 41 percent of girls in Arkansas have received one dose of the vaccine and 10.2 out of 100,000 women are diagnosed with cervical cancer each year. In Mississippi, only 40 percent of girls received one dose of the vaccine and the cervical cancer rate is 9.2 per 100,000 women.

Fifty-seven percent of girls nationally have received one does of the vaccine and the national cervical cancer rate is 8.2 per 100,000 women.

This new study confirms research showing that vaccine rates are much lower in the South than in other parts of the country. A 2013 study of older women, ages 18 to 26, found that between 2008 and 2010, 37.2 percent of young women in the Northeast had received at least one shot compared to 28.7 percent the Midwest and West, and just 14 percent in the South.

The newest study shows that cervical cancer rates and HPV vaccination rates tend to move up and down together. Though the authors could not prove causality, their finding suggest that increasing the uptake of the vaccine in a state could have a direct impact on cervical cancer rates and could help even out existing disparities between states.

Cervical cancer affects about 12,000 women each year in the United States, and about 4,000 women die from the disease.

Worldwide, the numbers are much higher. The clear majority of cervical cancers (91 percent) are caused by HPV, a highly contagious sexually transmitted disease (STD) that is spread from infected skin to uninfected skin. Around 79 million Americans are currently infected with HPV, and about 14 million people become infected each year.

Though the HPV vaccine has been shown to be safe and effective, it has been a tough sell since it came onto the market in 2006. Low vaccination rates reflect a general distrust of vaccines that stems from disproven data released in the late 1990s linking vaccines to the rise in autism.

This explains only part of the problem, because other vaccines are more readily accepted. In fact, the Centers for Disease Control and Prevention estimated in August that if 13-year-old girls had been given the vaccine at the same time they were given the other vaccines recommended for that age, 91.3 percent of them would have received at least one dose.

Some parents seem worried that vaccinating against as sexually transmitted disease would encourage sexual behavior in young girls. Others have said that the recommended age of 11 is too young to even discuss sexual behavior, despite lack of evidence that the vaccine changes a teen’s sexual behavior.

There is a lack of understanding among parents about the HPV vaccine and many parents don’t realize that it can actually prevent cancer.

Perhaps the most important research on the vaccine thus far are studies that show it is working. Despite the low vaccination rates, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

This applies to all teens, whether or not they were vaccinated. This may be a result of what public health experts refer to as “herd immunity”—if enough of the population is protected by a vaccine, that protection extends to the un-vaccinated as well. Among girls who had gotten the vaccine, however, the drop in HPV infections was even higher, at 88 percent.

Jennifer Moss, a doctoral student at the University of North Carolina Gillings School of Global Public Health and the author of the new study, told TIME, “These states could really use some interventions to increase the rates of HPV vaccination now, and hopefully there will be big dividends in the coming decades in terms of cancer mortality.”

Moss added that pediatricians play a critically important role.

“The factor that’s most strongly associated with HPV vaccination is whether a child’s health care provider recommends it,” she said. “We really need strong recommendations from health care providers to adolescent patients and their parents to get the vaccine.”

This week, LA County is reviving an at-home STI testing service, a new study shows that male circumcision can reduce rates of HIV among women as well as men, and an Australian company gets approval to produce a microbicide condom.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

LA Considers Bringing Back At-Home STI Tests

With both chlamydia and gonorrhea rates on the rise, the Los Angeles County Health Department is once again trying to promote the availability of at-home testing for sexually transmitted infections (STIs). The program began in 2009 when the department bought 10,000 kits for about $450,000 and advertised their availability to women ages 12 to 25. The goal was to increase testing and treatment among young women who did not have easy access to clinics or other health-care providers. About 9,000 kits were distributed. Most were sent back to the department for testing, and of those sent back about 10 percent tested positive for chlamydia and 3 percent for gonorrhea. But a health department official told the Los Angeles Daily News that after the first few years, interest in the program waned.

Since that time, rates of both STIs have increased in the county. Between 2009 and 2013, cases of chlamydia rose by 8 percent, while gonorrhea rose by 45 percent. These changes show that the STI epidemic in the county is worse than in California as a whole; during the same time period statewide, cases of chlamydia actual fell slightly and rates of gonorrhea rose by 13 percent.

Both chlamydia and gonorrhea are bacterial infections that are spread through genital secretions during oral, anal, or vaginal sex. They often have no symptoms, though they can cause some discharge and/or burning during urination in both men and women. Both can also be treated with antibiotics but if left untreated can cause pelvic inflammatory disease (PID), which in turn can cause scarring in the reproductive tract and infertility, mostly in women. An estimated 2.86 million cases of chlamydia and 820,000 cases of gonorrhea occur each year in the United States. Between 10 and 15 percent of chlamydia cases in women cause PID. Because most cases are asymptomatic, the Centers for Disease Control and Prevention (CDC) recommends annual chlamydia screening for all sexually active females 25 and under and for women older than 25 with risk factors such as a new sex partner or multiple partners.

At-home testing can be done by collecting a urine sample or using a cotton swab to collect secretions from the upper vagina. The sample is then sent to a lab. In the LA County program, women get their test results either through a website or via text message. Those who test positive are then told where they can go to get the antibiotics they need. Dr. Jonathan Fielding, director for the LA County Department of Public Health, told the LA Daily News, “This is a good approach for those who don’t feel comfortable going into a facility.”

For now the program remains limited to women because the county has not found a good home test for men, but Fielding did say they would look at that in the future.

Study: Male Circumcision Can Prevent HIV in Women

The results of a new study presented last week at the International AIDS Conference show that male circumcision can help reduce the spread of HIV among women as well as men. There have already been a number of studies that have shown that men who have been circumcised are at lower risk of contracting HIV. These results have led to interventions designed to increase the number of circumcised men in areas of Africa with a high prevalence of HIV. But until now, researchers were not sure whether such interventions also affected HIV rates in women.

This new study looked at women in Orange Farm, a town of 110,000 people outside of Johannesburg, South Africa. (One of the studies on male circumcision had taken place there as well.) Researchers surveyed 4,538 sexually active women ages 15 to 49 in three waves, in 2007, 2010, and 2012.

Participants were asked a number of questions about their sex lives, including the age at which they’d first had sexual intercourse, the number of lifetime partners they’d had, whether they’d always used condoms, and whether their partners were circumcised. Researchers also took blood to test the women for HIV. Among the 1,363 women who reported only having had circumcised partners, the HIV prevalence was 22.4 percent, compared with 36.6 percent among the remaining 3,175. According to analyses conducted by the researchers, this means that having only circumcised partners reduced these women’s risk of contracting HIV by 16.9 percent. Moreover, when researcher looked only at women under 29, they found a risk reduction of 20.3 percent.

Kevin Jean of the French National Institute for Health and Medical Research conducted the study and presented the results at the conference. He told the audience that the results provide a “compelling argument” to speed up interventions that provide voluntary male circumcision in areas with high rates of HIV.

Australia Approves Condom With STI-Killing Microbicide

Australian condom manufacturer Ansell, which makes LifeStyles brand condoms, has just won approval to start mass production in its home country on a condom lubricated with a microbicide that inactivates sexually transmitted viruses. Called Viva-Gel, the microbicide binds to viruses, preventing them from interacting with human cells. Viva-Gel has been shown to disable 99.9 percent of herpes, HIV, and human papillomavirus (HPV) cells on contact.

While this the gel should add extra protection for couples using condoms, many are still hoping that something will be released as a vaginal gel to help women—especially those whose partners refuse to wear condoms—protect themselves from STIs. It is not yet clear when such a product would be available, but Viva-Gel is in phase 3 clinical trials in the United States for use as a cure for bacterial vaginosis, a common infection caused by an imbalance of “good” and “bad” bacteria in a woman’s vagina. Though not an STI on its own, there is some evidence that sex, new sex partners, and multiple sex partners can contribute to an imbalance of bacteria in the vagina. More importantly, however, bacterial vaginosis can leave women more vulnerable to infection with other STIs.

The condom will be sold in Australia under the name LifeStyles Dual Protect. A Japanese condom-maker has also been approved to begin adding this microbicide to its condoms.

HPV Vaccine Rates Still Too Low

New data on vaccines among adolescents shows that despite a modest increase in overall vaccination coverage from 2012 to 2013, estimated coverage for the HPV vaccine remained low. In 2013, 57.3 percent of girls had received one dose of the HPV vaccine, compared to 53.8 percent the year before. More girls had received all three recommended doses in 2013 than in 2012 (37.6 percent, compared to 33.4 percent), but the CDC says this is still too low. In fact, the agency notes that if all pre-teen and teen girls got the HPV vaccine when they got other recommended vaccines for their age group (such as the vaccine for meningitis), 91.3 percent of all 13-year-old girls would have at least gotten the first dose. The actual numbers fall far short of that.

Vaccine coverage for young boys is even lower, but there was a bigger increase (13.8 percent) in the number of boys who got at least one dose of the HPV vaccine—it went from 20.8 percent in 2012 to 34.6 percent in 2013. There was also an increase in the percentage of boys ages 13 to 17 who had received all three doses (from 6.8 percent in 2012 to 13.9 percent in 2013).

The CDC pointed out that these data reflect great variation in vaccine rates between states. For example, only 39.9 percent of girls in Kansas received at least one dose, compared to 76.6 percent of those in Rhode Island. Similarly, only 11 percent of boys in Kansas received one dose, compared to 69.3 percent of boys in Rhode Island.

The slow uptake of the HPV vaccine is disappointing, as it has been shown to be very effective in preventing the strains of the virus that are most likely to lead to cervical cancer. A 2013 study, for example, found that the proportion of girls infected with the strains of the virus addressed by Gardasil (the first of the two HPV vaccines introduced) dropped from about 12 percent before the vaccine was available to 5 percent, which represents a drop of 56 percent. The drop applied to all teens, whether or not they were vaccinated. This may be a result of what public health experts refer to as “herd immunity”—if enough of the population is protected by a vaccine, that protection extends to the unvaccinated as well. Among girls who had gotten the vaccine, however, the drop in HPV infections was even higher, at 88 percent.

We can only imagine how far we could go in preventing HPV and cervical cancer if more young women and men were vaccinated. Unfortunately, some people still see the HPV vaccine as controversial since it protects against a disease that is sexually transmitted and because the recommendations suggest girls and boys get it as young as 9 to ensure that they’ve received all three doses before they become sexually active.

]]>http://rhrealitycheck.org/article/2014/07/29/week-sex-home-sti-tests-new-virus-killing-condom/feed/2HPV May Be Even More Common Than Previously Thoughthttp://rhrealitycheck.org/article/2014/05/21/hpv-may-even-common-previously-thought/?utm_source=rss&utm_medium=rss&utm_campaign=hpv-may-even-common-previously-thought
http://rhrealitycheck.org/article/2014/05/21/hpv-may-even-common-previously-thought/#commentsWed, 21 May 2014 20:32:01 +0000http://rhrealitycheck.org/?p=39898

A new DNA study found that more than two-thirds of healthy Americans have one or more strains of human papillomavirus in their skin, vagina, mouth, or gut. Researchers, however, insist that people should not overreact to these findings “until the harm or benefit of most of these strains becomes apparent.”

A new DNA study found that more than two-thirds of healthy Americans have one or more strains of human papillomavirus (HPV) either in their skin, vagina, mouth, or gut. Interestingly, however, only 4 percent of participants had either of the two strains responsible for most cervical cancers. Most of the HPV infections found were harmless and had no negative impact on health, and based on this study researchers are beginning to question whether different strains of the virus actually keep each other in check the way that “good” and “bad” bacteria are known to do.

Though HPV gets a lot of attention as the most common sexually transmitted infection (the Centers for Disease Control and Prevention estimates 14 million new infections per year), there are 148 strains of HPV that have been discovered thus far and only 40 of them are known to infect the genitals. Two of these strains, 6 and 11, are responsible for most cases of genital warts, and another two, strains 16 and 18, are known to be responsible for 70 percent of cervical cancers. Other strains, however, focus on different body parts. There are some, for example, that are known to cause warts on the neck or face, while some are responsible for plantar warts on the bottom of the feet. Many HPV infections, however, carry little health risk and, in some cases, the body is able to rid itself of the virus.

In an effort to better understand the extent of HPV in the human body and its effect on health, researchers at New York University’s Langone Medical Center analyzed DNA samples collected as part of the National Institutes of Health’s (NIH) Human Microbiome Project. The results found that 71 of the 103 participants had HPV, but only four had the strains known to cause cervical cancer. In total, researchers found 109 strains of the virus. Most study participants had HPV infections in the skin (61 percent) followed by the vagina (41 percent), the mouth (30 percent), and the gut (17 percent).

Taking a closer look, researchers found that skin samples included 80 strains of HPV, 40 of which were only found in skin. They found 43 types of HPV in vaginal tissues, 20 of which were only found there. The mouth samples contained 33 types of the virus, five of which were exclusively oral. As for the gut, they found six strains of HPV there, but all of those strains were also found in other organs.

Zhiheng Pei, a pathologist who was one of the authors of this study, said the findings suggest that current screening tests, which are limited to about a dozen strains of the virus, are inadequate. He added that “broader detection methods and comprehensive diagnostic tests are needed to more accurately assess people’s ‘true’ HPV infection status.” That said, Pei cautions that people should not overreact to these findings “until the harm or benefit of most of these strains becomes apparent.”

These findings also lay the ground work for the idea that infection with multiple strains of HPV may have benefits. Pei explained, “Our study offers initial and broad evidence of a seemingly ‘normal’ HPV viral biome in people that does not necessarily cause disease and that could very well mimic the highly varied bacterial environment in the body, or microbiome, which is key to maintaining good health.” Co-author Yingfei Mai added, “The HPV ‘community’ in healthy people is surprisingly more vast and complex than previously thought, and much further monitoring and research is needed to determine how the various non-cancer-causing HPV genotypes interact with the cancer-causing strains, such as genotypes 16 and 18, and what causes these strains to trigger cancer.”

In the meantime, the authors believe that people should take advantage of the available HPV vaccines, both of which cover strains 16 and 18 and one of which also covers the two strains known to cause genital warts. Their hope is that this research can be the basis for a broader vaccine that will cover HPV infection in other parts of the body as well. The researchers are also working to develop new screening tests that can detect additional strains of the virus.

The South Carolina Senate Medical Affairs Committee passed a bill on Thursday that would allow—but not require—the state to create brochures about the HPV vaccine and provide vaccines to underinsured seventh graders. The bill, however, faces opposition, including from the governor.

On Thursday, the Medical Affairs Committee of the South Carolina Senate passed a bill aimed at encouraging parents to get their children vaccinated against human papillomavirus (HPV). The bill would allow, but not require, the state to publish brochures about the vaccine. It would also allow—but, again, not require—the state to offer free HPV vaccines to young people entering seventh grade who are not covered by private insurance or the federally funded Vaccines for Children program. The bill, however, faces opposition from many lawmakers in the state, including the governor.

If the bill is signed into law, an estimated 2,400 students would be eligible for the vaccine, but provision of the vaccines would depend on the availability of federal and state funding. Sen. Ray Cleary (R-Georgetown), chair of the Medical Affairs Committee, told the Associated Press that he supported the bill because it is in everyone’s best interest to educate parents, so they can make an informed decision. He went on to express frustrations with critics who are trying to argue that the bill would make the vaccine mandatory. “What part of optional do they not read in the bill? I don’t understand,” he said. “The bill says it is not mandated. It is an informational thing that DHEC [the Department of Health and Environmental Control] will provide to let people know about it.”

One opponent who seems to be arguing that the bill mandates the vaccine is Gov. Nikki Haley. Her spokesperson, Doug Mayer, said, “As a mother of a teenage daughter, Governor Haley, like the majority of South Carolinians, believes that health decisions like this are best left up to parents and doctors—not state government.”

In 2012, the governor vetoed a bill that also would have offered HPV vaccines. As a state representative, however, Haley sponsored a bill that would have implemented an opt-out vaccine program for seventh-grade girls.

According to the Centers for Disease Control and Prevention, approximately 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year. Two strains of the virus, 16 and 18, are responsible for 70 percent of all cases of cervical cancer. Approximately 12,000 women in the United States are diagnosed with cervical cancer each year, and about 4,000 die. HPV can also cause cancer of the penis and anus, and is responsible for a recent increase in cases of head and neck cancers.

HPV is easily spread from infected skin to uninfected skin. Transmission of HPV can be prevented by condoms, but only if the infected skin is in an area covered by the condom. If it is on an area such as a man’s scrotum, condoms cannot help reduce transmission.

Transmission can also be prevented by the two available vaccines—Gardasil and Cervarix. Research shows the vaccines are working. A 2013 study that looked at the impact of Gardasil found that despite the fact that only half of teen girls had gotten one dose of the vaccine and fewer than a third had gotten the recommended three doses, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

The bill faces opposition in the full senate, including from those members of the Medical Affairs Committee who have already voted against the bill once. Sen. Shane Martin (R-Spartanburg) said he was worried the bill would eventually need funding. He also told the AP, “Our students shouldn’t be forced to do anything like that. It’s not an airborne disease and abstinence works every time.”

]]>http://rhrealitycheck.org/article/2014/05/19/south-carolina-senate-committee-approves-hpv-vaccine-bill-amid-opposition/feed/8Parents’ Distrust of Vaccines May Be Even Harder to Counter Than We Thoughthttp://rhrealitycheck.org/article/2014/03/06/parents-distrust-vaccines-may-even-harder-counter-thought/?utm_source=rss&utm_medium=rss&utm_campaign=parents-distrust-vaccines-may-even-harder-counter-thought
http://rhrealitycheck.org/article/2014/03/06/parents-distrust-vaccines-may-even-harder-counter-thought/#commentsThu, 06 Mar 2014 15:03:53 +0000http://rhrealitycheck.org/?p=34535

Despite overwhelming scientific evidence showing that vaccines are safe and effective, many parents have become skeptical. Efforts to encourage these parents to change their minds have most often focused on correcting misinformation. A new study, however, suggests that this approach may backfire.

Though there is a great deal of scientific evidence to prove that vaccines are safe and effective, many parents in recent years have become skeptical of the childhood immunizations designed to prevent illness like measles, mumps, chickenpox, and even the flu. Efforts to encourage these parents to change their minds have most often focused on correcting the misinformation on which these beliefs are thought to be based. A new study by social science researchers, however, suggests that this approach may backfire.

Much of the distrust of vaccines can be traced back to a 1998 study in which British researcher Andrew Wakefield looked at the records of just one dozen autistic children and determined that the MMR (measles, mumps, and rubella) shot was the cause of their condition. The medical community was shocked by this assertion and many did not believe the findings (especially because the study was so small). It the coming years, a number of researchers attempted to recreate the study and no one could confirmhis conclusion. Moreover, numerous other studies found no link between vaccines and autism, yet the popular press had already seized on the data, parents had been sufficiently whipped into a frenzy, and anti-vaccine groups and websites began sprouting up everywhere.

By the time the news hit in 2011 that Wakefield had a financial motive for coming to the conclusion that he did and that there was evidence that he had deliberately falsified information, the damage to the reputation of not just the MMR but all vaccines had been done. While public health experts scrambled to clarify the misinformation of the previous decade, anti-vaccine groups and celebrity spokespeople like Jenny McCarthy continued to suggest, despite evidence to the contrary, that vaccines were unsafe and led to autism. The results were frightening as the percentage of children who got vaccinated plummeted, and cases of long forgotten illnesses like mumps surged.

Those of us working in the sexual health field were also affected by the growing distrust as the vaccines to prevent the human papillomavirus (HPV) were released during this time. The HPV vaccine would have been a bit of a tough sell even without the doubt surrounding other inoculations, because parents sometimes fear that prevention efforts against sexually transmitted diseases—whether in the form of shots or condoms—will increase sexual behavior. Moreover, the Centers for Disease Control and Prevention (CDC) suggests that the shot be given starting at age 11 to ensure that all three required doses have been received before a young person becomes sexually active. Traditionally, parents don’t like to think about their children as even potential sexual beings, especially at such a young age. For these reasons and others, just 33.1 percent of girls ages 13 to 17 had received all recommended doses of the vaccine by 2012. (Though the CDC does now also recommend that boys be vaccinated, the early push was limited to girls).

So while other public health experts have spent the last decade trying to correct the misinformation about vaccine safety and the link to autism, sexual health experts have been providing similar information designed to reassure parents about the HPV vaccine specifically; it is safe and effective, it does not cause sexual activity, and it does prevent cancer. If this new study is correct, however, we may all be doing it wrong.

Researchers at Dartmouth College in New Hampshire surveyed over 1,700 parents to determine their beliefs about vaccines. Specifically, they wanted to know if the parents believed the idea that the MMR vaccine caused or could cause autism. After identifying the parents who believed this myth, the researchers tried one of four methods commonly used to correct such misbeliefs. Parents were either given information by a health authority that explained there was no connection, given information about the three diseases that the MMR vaccine protects against, shown pictures of kids suffering from these diseases, or told a story about a baby who almost died from the measles.

After being given this positive information about the vaccine, parents were less likely to believe that the MMR caused autism. Don’t get too excited, however, because the good news ends there. Despite their new-found faith in vaccines, these parents were less likely to say they would vaccinate their own child than they had been at the start of the study. When the study began, those parents who were strongly opposed to vaccines said that at best there was a 70 percent chance they’d vaccinate their children in the future. After being given the pro-vaccine information, this went down to 45 percent. (The study just measured intent to vaccinate, it did not follow the parents or children to see what actually happened.)

The researchers say further studies are needed to pin point the cause of this reaction but they think it is linked to self-esteem and self-image. If you are somebody who believes strongly in the link between autism and vaccines and you are presented with information that suggests your beliefs are wrong, your self-esteem and self-image may be shattered. One natural reaction to this is to dig in your heels, stick to your beliefs, and start looking for proof that you were right all along.

Lead researcher Brendan Nyhan explained to LiveScience, “We suggest that people are motivated to defend their more skeptical or less favorable attitudes towards vaccines.” Nyhan noted that as of yet we don’t really know what works to change their minds and said that as we search for new methods, “We shouldn’t put too much weight on the idea that there’s some magic message out there that will change people minds.”

I had my own experience trying to craft a persuasive argument to a skeptical parent just last week. We were sitting in the waiting room of my pediatrician’s office noting how different it was to bring a 3-year-old who was dancing around the waiting room loudly (me) and a 14-year-old who was curled in a chair eyes planted on her phone (her). The office assistant came up and gave her a brief written description of the vaccines her daughter was scheduled to get but said that it was obviously her choice. She held up the papers one after the other and said, “We’ll do this one but let’s hold off on this.” The nosy sex educator in me went on alert. I knew it had to be the HPV vaccine. I looked at her inquisitively and hoped that since we’d already been chatting, she would tell me what had just transpired. She picked up the cue and explained that she’d been intending for her daughter to get the HPV shot at this visit but just before she’d left the house she had checked email and a headline came through claiming a new study found that very vaccine unsafe. I asked her for details but she had none because she hadn’t read the article yet, just the headline. Still, she said, it seemed like a sign from the universe.

Despite the fact that it was really none of my business, I feel strongly about the benefits of the HPV vaccine (see this article for more) and could not let the chance to change even this one parent’s mind slip away. I scrambled for the right messages, facts, and tone. I tried to explain my “credentials” on the subject. Then said from all the research I’d done it was a really safe vaccine and added that it had been shown to be working, which was great because pretty much everyone our age has HPV. I tried to stay away from too much detail lest I sound like I was launching into a prepared diatribe. Ultimately, after making just a few points in the vaccine’s favor, I agreed that it was weird she should see that email at that very moment and said I could understand her seeing it as a “sign.” I ended by telling her she should talk to the regular doctor (who was out that day) because I know he is very pro-vaccines and she undoubtedly trusts him more than some random stranger in the waiting room who claims to be an expert.

She did not get her daughter vaccinated that day, and I will never know whether she does in the future. Still, I wonder whether my words had any impact. And after this study, I wonder if any words could have.

Though I find the results of this study—and the human nature that they spotlight—fascinating, I hope they are not too discouraging to those dedicated public health professional who have spent the last decade trying to convince parents that vaccinating their kids, whether against a host of childhood illness or HPV and cervical cancer, is the right thing to do. Yes, we just found out that it may be even harder to change somebody’s mind than we thought, but we have to keep on trying.

]]>http://rhrealitycheck.org/article/2014/03/06/parents-distrust-vaccines-may-even-harder-counter-thought/feed/44One More Time, With Feeling: The HPV Vaccine Does Not Encourage Sexual Behaviorhttp://rhrealitycheck.org/article/2014/02/05/one-time-feeling-hpv-vaccine-encourage-sexual-behavior/?utm_source=rss&utm_medium=rss&utm_campaign=one-time-feeling-hpv-vaccine-encourage-sexual-behavior
http://rhrealitycheck.org/article/2014/02/05/one-time-feeling-hpv-vaccine-encourage-sexual-behavior/#commentsWed, 05 Feb 2014 14:01:04 +0000http://rhrealitycheck.org/?p=32573

Despite a mounting body of evidence to the contrary, there continues to be a fear among adults that vaccinating young people against an STD is akin to giving them a license to have sex. Yet another study promises this isn't going to happen.

The human papillomavirus (HPV) vaccine prevents cancer, and yet it remains controversial. Because HPV is sexually transmitted, and because it is recommended that young people get the vaccine around age 11, some parents remain reluctant to have their children vaccinated. The fear: that giving an 11 year old protection against a sexually transmitted disease (STD) will encourage him or her—though, let’s face it, mostly her—to be sexual active.

Well, once again, a study says this isn’t going to happen.

This most recent study, published online in the March issue of Pediatrics, looks at the perceptions of young people who had received the vaccine. Researchers recruited 329 young women between the ages of 13 and 24, both sexually experienced and not, and asked them two important questions: After receiving the vaccine, do they feel it’s still necessary to practice safer sex, and do they think they’re protected against other STDs? Participants were also asked about their sexual behavior. The survey was repeated two months and then six months after the vaccine was given.

The findings show that immediately after vaccination, the majority of respondents believed it was still important to practice safer sex, and most also understood that the shot only covers HPV and not any of the other STDs that they might be exposed to during unsafe sex. Neither age nor sexual experience were associated with those beliefs.

The participants’ sexual behavior was consistent with their answers. Among those who were sexually active when they got the vaccine, 61 percent said they had used a condom the last time they had sex during the two-month survey, and 62 percent said so during the six-month survey. Moreover, only 20 percent of these young women said they had had more than two partners since the last survey at the two-month mark, and only 34 percent of participants said so at the six-month mark.

The misguided fear about the HPV vaccine is based on the notion that once young people get vaccinated they will perceive themselves as being less at-risk of STDs and therefore have more or riskier sex. The authors’ analysis showed that this was not the case. There was no correlation between perceived risk right after the vaccine and sexual behavior in the next few months for almost every group of girls (when looked at by age or sexual experience). In fact, the only correlation they found is that sexually inexperienced young women ages 16 to 21 who inaccurately believed that they were protected from other STDs because of the vaccine were actually less likely to become sexually active during the six months after they got the vaccine than those who knew the vaccine only protected against HPV. This is the opposite of the expected (or feared) correlation. Jessica Kahn, one of the researchers, told Healthline, “Whatever they believed, those key beliefs around the need for safe sex, and whether they’re protected against other sexually transmitted infections, they were not associated with riskier behaviors.”

This study is far from the first to find that the HPV vaccine does not increase sexual risk behaviors. A January 2012 study sponsored by the Centers for Disease Control and Prevention (CDC) found that the HPV vaccination is not associated with being sexually active or with the number of sex partners young women have had. Moreover, it found that among sexually active adolescents ages 15 to 19, those who have received the HPV vaccine are more likely to always wear a condom.

As RH Reality Checkreported in October 2012, another study followed 1,400 girls in Atlanta for three years after they’d received their HPV vaccine; the researchers examined their medical records for markers of sexual risks such as pregnancy tests, contraceptive counseling, or STD diagnoses. They found no differences between girls who got the HPV vaccine and girls who got other vaccines but not the HPV vaccine. One of the authors of the study told NBC News at the time, “We feel this is reassuring. We can start to move beyond these concerns.”

Unfortunately, we do not seem to have moved beyond concerns of promiscuity linked to the HPV vaccine. A study from last spring found that fewer teens were receiving HPV vaccines than other recommended vaccinations and that parents’ reason for not vaccinating their children included “[he/she] is not sexual active” or “[he/she] is not appropriate age.” Other reasons for not vaccinating included a lack of information and safety concerns.

It is clear that we have to do a better job educating parents about the HPV vaccine. We have to reassure them that the vaccine is safe and effective, that it has the potential to prevent cancer, and that there is a growing body of research that shows exposure to the vaccine (and the conversations that often come with it) will not increase the likelihood that their child becomes sexually active or engages is risky sexual behavior.

Put another way: The vaccine will not make young people sexually promiscuous, but it may save their lives.

We also have to remind people that HPV is extremely widespread. According to the CDC, approximately 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year. Most people who have HPV will have no symptoms or health problems and may never even know they have it. Some people will get genital warts, which may go away on their own or may need to be removed by a health-care provider. And certain strains of the virus, if left untreated, can lead to cervical cancer. Approximately 12,000 women in the United States are diagnosed with cervical cancer each year, and about 4,000 die. HPV can also cause cancer of the penis and anus, and is responsible for a recent increase in cases of head and neck cancers.

HPV is easily spread from infected skin to uninfected skin. Transmission of HPV can be prevented by condoms, but only if the infected skin is in an area covered by the condom. If it is on an area such as a man’s scrotum, condoms cannot help reduce transmission. Of course, transmission can also be prevented by the available vaccines. Gardasil, which was introduced in 2006, provides protection against four common strains of the virus: the two that account for 70 percent of cervical cancers and the two that account for 90 percent of genital warts. A second vaccine, called Cervarix, was approved in 2009 and protects against the two strains that cause cervical cancer.

Research shows the vaccines are working. A 2013 study that looked at the impact of Gardasil found that despite the fact that only half of teen girls had gotten one dose of the vaccine and fewer than a third had gotten the recommended three doses, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

Imagine what could happen if more young people got the vaccine—if everyone stopped worrying about raising a generation of promiscuous young people and started working toward a generation without cervical cancer?